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All Journal Medula Berkala Kedokteran
Parinding, Imanuel Taba
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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The Utility of Alvarado Score, RIPASA Score, NLR, and PLR for Predicting Acute Appendicitis Halim, Sanjaya; Parinding, Imanuel Taba
Berkala Kedokteran Vol 20, No 2 (2024)
Publisher : Fakultas Kedokteran Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20527/jbk.v20i2.20575

Abstract

Acute appendicitis requires fast and precise diagnosis. Delay in diagnosis will increase the risk of complications, as well as morbidity and mortality. Modalities such as ultrasound or CT scan are not always available. The purpose of this study was to analyze the Alvarado score, RIPASA score, NLR and PLR to predict the diagnosis of acute appendicitis in a type C Hospital. This research is an observational analytic study using a cross-sectional approach, from medical records. The diagnosis is made by surgeon based on clinical, laboratory, imaging findings, then confirmed by surgery and histopathology. From a total of 32 patients, there were 21 patients (66%) with a final diagnosis of acute appendicitis, and 11 patients (34%) with a final diagnosis of non-acute appendicitis. Alvarado score ³7 has an AUC value of 81.6%, with a sensitivity of 57.14%, a specificity of 81.82%. RIPASA score ³7.5 has an AUC value of 84.6% with a sensitivity of 80.95%, a specificity of 81.82%. NLR with a cut-off value of >4.49 can be used to detect acute appendicitis, and a cut-off value of >9.13 for perforated appendicitis. PLR with a cut-off value of >172.2 can be used to detect perforated appendicitis.
A Kasus Langka: Intususepsi Pada Orang Dewasa Dona, Adma Hayani; Pramudya, Ricky; Parinding, Imanuel Taba
Medula Vol 14 No 11 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i11.1474

Abstract

Intussusception is defined as the invagination of one segment of intestine into the next. Unlike children, intussusception in adults is rare. The incidence of intussusception in adults is around 1%-5% of intestinal obstruction with an average age of 50 years. Compared with intussusception in children, intussusception in adults is different because 90% of cases are complications of pathological starting points, including polyps, carcinoma, strictures, adhesions, and Meckel's diverticulum. Meanwhile, the incidence of idiopathic intussusception is around 10% of cases. A 39-year-old woman with a history of right lower abdominal pain for 3 days came to the emergency department accompanied by vomiting, no bowel movements and a history of abdominal massage. Physical examination found a positive Mc Burney sign, a sausage-like mass was palpable, abdominal ultrasonography showed a doughnut sign and an impression of ileo-caecal intussusception. The patient underwent exploratory laparotomy and appendectomy. During the operation, ileocaecal invagination into the ascending colon was seen, then a milking procedure was performed. The patient was discharged in stable condition on the fifth day of hospitalization. Management of intussusception depends on the part of the intestine involved. Reduction of acute intussusception is an emergency procedure and should be performed immediately after diagnosis in preparation for possible surgery. Management can be done operatively or non-operatively. Resection of the intestine is the final choice if the intestinal viability is compromised or there are pathological points. Early diagnosis and timely intervention greatly affect the patient's prognosis.
Co-Authors Dona, Adma Hayani Halim, Sanjaya Pramudya, Ricky